Canalicular involvement in dog bite related eyelid lacerations

Abstract

Purpose: To evaluate the incidence of canalicular involvement in periocular dog bite injuries. The majority of eyelid injuries do not involve the canaliculi. It has been our observation that periocular dog bite injuries involve the canaliculi more frequently than lacerations due to other mechanisms.

Methods: In this retrospective case series, the records of all patients referred to the oculoplastics service at the Massachusetts Eye and Ear Infirmary with a dog bite injury between 1995 and 2005 were reviewed. Sixty-eight cases of eyelid lacerations due to dog bites were identified. A control group was constructed consisting of 92 patients referred for management of periocular eyelid lacerations not due to dog bite. Variables assessed included canalicular involvement, age, sex, associated injuries, and surgical repair.

Results: Canalicular injuries were present in 45 patients (66%) in the dog bite group and 34 patients (37%) in the control group (p<0.01). In the dog bite group, 7 injuries (16%) involved only the superior canaliculus, 33 (73%) only the inferior canaliculus, and 5 (11%) involved both. In the control group, 12 injuries (35%) involved only the superior canaliculus, 18 (53%) only the inferior canaliculus, and 4 (12%) involved both. The average time from presentation to repair was 0.53 days (range, 0-3 days). Four patients had extensive tissue loss that prevented stenting.

Conclusions: Periocular dog bites have a propensity for involvement of the lacrimal canaliculus. We present the largest series to date of periocular dog bite injuries. The index of suspicion for canalicular lacerations should be raised when evaluating patients with dog bite injuries.